Functional communication ability in frontotemporal lobar degeneration and Alzheimer's disease

Abstract

Functional communication is crucial for independent and efficient communicative behavior in response to every day activities. In the course of dementia progression, cognitive losses may impair these abilities. For this reason, functional communication assessment should be part of a formal assessment to quantify and qualify the impact of deficiency on patients’ lives.ObjectiveTo compare functional communication abilities in fronto-temporal lobar degeneration (FLTD) and Alzheimer’s disease (AD).MethodsSix AD patients (mean age: 82.50±2.66 years; mean education: 5.67±3.61 years), and eight FTLD patients (mean age: 57.13±9.63 years; mean education: 10.86±6.91 years) had their close relatives answer the Functional Assessment of Communication Skills for Adults (Asha-facs) . Statistical analyses correlated the performance on each of the Asha-facs domains (social communication, communication of basic needs; reading, writing, number concept and daily planning) between both groups.ResultsAnalyses showed that functional communication was similar for AD and FTLD patients. Only two items had statistical difference, namely ‘Comprehension of inference’ (AD 6.7±1.33; FTLD 2.43±2.30, p=0.017) and ‘capacity to make basic money transactions’ (AD 2.17±2.04; FTLD 4.00±0.90, p=0.044). Comparison among the four domains’ mean scores revealed no significant difference.ConclusionThe Asha-facs is a useful instrument to characterize functional communication abilities in both FTLD and AD. Nevertheless, the analysis presented for this sample showed that the Asha-facs could not discriminate which aspects of the FTLD and AD differed.

Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges

“…The Direct Assessment of Functional Performance (DAFS) ( 245 ) was administered for the study of patients with FTD ( 238 ) (unlike the DAD, this is a performance-based test). In addition, Carvalho et al ( 246 ) used the Functional Assessment of Adult Communicative Skills (Asha-Facs) ( 247 ) in patients with FTD and AD. The results showed similar performances in both groups of patients ( 246 ).…”

“…In addition, Carvalho et al ( 246 ) used the Functional Assessment of Adult Communicative Skills (Asha-Facs) ( 247 ) in patients with FTD and AD. The results showed similar performances in both groups of patients ( 246 ). Finally, in Chile, the T-ADLQ showed promising results for evaluating functional impairment in FTD ( 243 ).…”

Functional Status in Behavioral Variant Frontotemporal Dementia: A Systematic Review

“…Two studies failed to find differences among patients diagnosed with FTLD and AD on assessments of functionality. Carvalho et al [ 13 ] found no significant difference in functional communication between AD and FTLD patients. Similarly, Bahia et al [ 14 ] found no significant differences between patients with AD and FTLD on DAD scores.…”

Funcionalidade e desempenho cognitivo na demência frontotemporal variante comportamental

“…Estes pacientes têm como característica principal, nas fases iniciais da doença, prejuízos diretos no desempenho de funções executivas, sobretudo na tomada de decisão, havendo alentecimento nessa função cognitiva (Allegri et al, 2001 (Dubois et al, 2000;Kertesz et al, 2000) e a Entrevista Executiva EXIT-25 (Royall et al, 1992). Bahia et al (2008) Para o diagnóstico de DFTvc, ressalta-se que tanto a neuroimagem estrutural (tomografia computadorizada ou ressonância magnética de crânio) quanto funcional (tomografia por emissão de fóton único-SPECT ou tomografia por emissão de pósitrons-PET) podem ser normais nas fases iniciais da doença, mesmo quando o paciente apresenta alteração comportamental evidente (Eslinger et al, 2012).…”

“…Em Carvalho et al (2008), não houve diferença em aspectos da comunicação funcional entre pacientes com DA e DLFT. Bahia et al (2008) também não encontraram diferenças significativas entre pacientes com DA e DLFT para os escores da DAD. Na amostra, a DAD não apresentou boa acurácia no diagnóstico diferencial entre estes tipos demências.…”